Donation Form

"Come prepare for another championship season with us!"

* INSTRUCTIONS *

1) Parent/Guardian please fill out and approve the
Parent Release & Consent Waiver, along with Sign-up Information.

3) Include your Payment details and Submit the entire page.

This form allows for pay by check, debit card, or a credit card.

If you need assistance or have questions about signing up,
please contact Matt Livingston at [email protected].

AGREEMENT & INFORMATION MUST BE FILLED OUT ACCURATELY AND COMPLETELY

Program Selection, Participant Information, Health, Insurance Details & Payment

To be filled out by Parent or Legal Guardian.
Please submit 1 form per participant. Thank you.

Program Cost

Select Session (SESSION 1 IS FULL)

Your Relationship to Participant:

Participant’s First Name

Participant’s Last Name

Participant's Date of Birth

Grade Level in Fall 2024

T-Shirt Size

HEALTH HISTORY & HEALTH INSURANCE
If no conditions exist enter NONE. Please list and describe all physical or emotional limitation(s) your child may have, including but not limited to: Allergies, Vision, Asthma, Heart Murmur, High Blood Pressure, etc.

I confirm that the participant is covered by Health Insurance and that the health information provided is accurate.

Health Insurance Carrier

Insurance Policy Number

By checking this box you confirm that you have read and agree to all terms in the above SDUHSD/TPHSF HOLD HARMLESS, RELEASE OF LIABILITY AGREEMENT FOR EXTRA CURRICULAR ACTIVITIES AND THE PARENT RELEASE AND CONSENT WAIVER.

I confirm that I have read and agree to the SDUHSD/TPHSF HOLD HARMLESS, RELEASE OF LIABILITY AGREEMENT FOR EXTRA CURRICULAR ACTIVITIES AND THE PARENT RELEASE AND CONSENT WAIVER AND WAIVER OF LIABILITY.

By checking this box you confirm that all the information provided in the above PARTICIPANT HEALTH INFORMATION is accurate to the fullest extent.

I confirm that all the information provided in the above PARTICIPANT HEALTH INFORMATION is accurate to the fullest extent.

By clicking this box you confirm the use of electronic communication as your form of consent.

By checking here, you agree to the use of your electronic consent in lieu of an original signature on paper. You have the right to request to sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged and no special hardware or software is required to view it. Make sure that we have your current email address. I agree via electronic consent to the terms above.

Parent/Guardian Information

First Name

Last Name

Address

City

State/Province

Zip/Postal Code

Cell/Emergncy Phone

Help Us Cover Costs - Tax Deductible Credit Card Processing Fees.

Simply leave "Yes!" checked below to ensure that 100% of your camp fees go to your team/booster.

Yes! I want to add the cost of credit card processing fees (3%) so that the full camp fee of $0.00 will go to your team/booster. The total payment amount will be $0.00. (For eCheck or ACH, there are no additional fees)No. I will pay $0.00 and TPHS Football will cover the processing costs.

Payment Information

Payment Options

Choose 'Bank Account' to Pay with a Check: Then simply click on the ? Help icon to see how to enter the routing and bank account numbers directly from one of your checks.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Privacy Policy: We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through the TPHS Foundation web site. We use this information to process your payment.

Terms/Conditions: By submitting your payment, you authorize us to charge your account for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.